Electromyographic biofeedback for relief of tension in the facial and throat muscles of a woodwind musician

Electromyographic(EMG) biofeedback, for the relaxation of specific throat and facial muscles, was given to a woodwind musician. The patient had a nineteen-year history of tics and high levels of tension in his throat and facial muscles. Eventually these problems progressed to a point that interfered with his ability to perform as a professional woodwind musician. Following detoxification from alcohol and Dexamyl, and after a period of psychotherapy, EMG biofeedback relaxation training was started for the muscles specifically showing chronically high tension levels. The EMG training consisted of four phases designed to help the patient progressively lower tension and generalize these newly learned techniques to his professional life. He had a total of twenty treatments of approximately 45 minutes each. This procedure resulted in dramatic reductions in tension levels of the specific throat and facial muscles along with increased proficiency as a muscician and in psychological functioning.     

PSYCHOTHERAPY—A Concept for the Nonpsychiatric Physician

Patients tend to repeat with their physician, as with other significant people in their lives, their earlier previous patterns of behavior. The physician as well as the patient is involved in the physician-patient relationship. He will tend to respond to his patients in accordance with his earlier life experiences and his characteristic repetitive behavioral pattern. For both physician and patient, the relationship between them extends beyond the immediate reality situation.Psychotherapy is the utilization of psychological measures in the treatment of sick persons and the deliberate utilization by the physician of the physician-patient relationship for the benefit of the patient. The kind of psychotherapy that is practical and utilizable by the nonpsychiatric physician is that which uses education, reassurance, support and the management of the patient''s problems either directly or indirectly or through the intermediary of other people or agencies.The symbolic aspect of the physician-patient relationship is based essentially on the fact that a sick person, because of his anxiety and because of the threat to his physical and psychic integrity, is more dependent and more anxious than he would be if he were well, and therefore he has a correspondingly greater need for the authoritative and protective figure he finds in the physician.Psychotherapy is not directed exclusively to the treatment of flagrantly or obviously neurotic or psychotic patients. It should be and is directed to all sick persons. Limitations in psychotherapy are set by various determinants, among which are the nature of the precipitating factor in the illness, the nature of the sick person, the skill, knowledge and abilities of the physician, and the nature of the physician-patient relationship. In psychotherapy, as in all medicine, the physician should not do anything which may disturb the patient if the disturbance is of no value or if it cannot be followed through with special skills.     

Current theories on the etiology and treatment of Gilles de la Tourette's disease]

Gilles de la Tourette syndrome is a condition marked by: (1) onset usually in childhood and adolescence, i.e. between 2 and 15 years of life; (2) violent facial tics and echolalia; (3) increased excitability and apathy; (4) progressive increase in symptoms intensity; (5) chronic course. This syndrome is threefold more frequent in men than in women. None hypothesis concerning its etiopathogenesis (genetic, organic, organic-functional, psychomotor, and mixed) does explain its origin. Many cases respond with some degree of relief to neuroleptics, carbamazepine, clonidine, and glucocorticosteroids. Neurosurgery and psychotherapy are also of value. Haloperidol is commonly considered the most effective in this syndrome.     

NON-DIRECTIVE PSYCHOTHERAPY

Psychotherapy is a word to describe an age-old process. It would be better not to speak of psychotherapy, but of psychotherapies. Specialists are not the only ones who act as psychotherapists, since every human being fills this role at one time or another. Besides this, no two persons follow an identical approach. Finally, all therapists change technique constantly. The kinds of psychotherapy must therefore approach infinity.Some physicians appear to assume that only one type of psychotherapy may claim a scientific basis. Although Freud first put psychotherapy on a scientific path, there is no reason to say that Freud must be the last in this field.Over the past few years a new trend has started in psychotherapy which deserves close study. This new trend challenges some old beliefs and gives a new tool to help patients of some types. It is called non-directive or client-centered psychotherapy. This therapy does not try to solve the patient''s problems for him, but rather establishes the conditions under which a patient can work out his own salvation.Each year non-directive psychotherapy grows in importance. Much can be learned from the method.     

Non-directive psychotherapy

Psychotherapy is a word to describe an age-old process. It would be better not to speak of psychotherapy, but of psychotherapies. Specialists are not the only ones who act as psychotherapists, since every human being fills this role at one time or another. Besides this, no two persons follow an identical approach. Finally, all therapists change technique constantly. The kinds of psychotherapy must therefore approach infinity.Some physicians appear to assume that only one type of psychotherapy may claim a scientific basis. Although Freud first put psychotherapy on a scientific path, there is no reason to say that Freud must be the last in this field. Over the past few years a new trend has started in psychotherapy which deserves close study. This new trend challenges some old beliefs and gives a new tool to help patients of some types. It is called non-directive or client-centered psychotherapy. This therapy does not try to solve the patient's problems for him, but rather establishes the conditions under which a patient can work out his own salvation. Each year non-directive psychotherapy grows in importance. Much can be learned from the method.     

Brief Psychotherapy: Current Status

In the past decade, stimulated by public concern with issues of mental health, there has been a new spurt of interest in techniques of brief treatment with circumscribed goals. These are applicable to groups as well as to the single patient. There are still differences of opinion about the effectiveness of brief psychotherapy, particularly the lastingness and depth of the results obtained, yet it is often highly beneficial, especially to previously well-functioning individuals who are involved in a situational crisis. Although probably the best results of brief psychotherapy are with disturbances of moderate severity and recent onset, in practice, it is often tried with a wide spectrum of patients. Brief psychotherapy aims at relief of the patient''s major current conflicts rather than at change of his personality structure, which generally requires long-term treatment. Brief psychotherapy is of special relevance for the general physician because the patients whom he sees in large numbers are precisely those best suited for this form of treatment.     

Privileged Communications—The Effect of California's New Evidence Code As It Concerns Physicians and Psychotherapists

A physician has an ethical duty to hold in confidence communications made to him by his patient. A legal recognition of this ethical duty is found in the concept of privilege, which is the subject of this article. January 1967 will bring to California physicians a new protection for patients'' communications. The physician-patient privilege has been redefined to include confidential communications made during diagnostic evaluation, those made to non-licensed physicians, interns and medical aides, and those overheard by eavesdroppers. There has been added a psychotherapist-patient privilege designed to facilitate communications required in psychotherapy as well as in behavioral research.This paper first presents a brief historical background and discusses the protections and limitations afforded by the new California Evidence Code. There follows a section on the psychotherapist-patient privilege with the recommendation that in the context of psychotherapy, patients of physicians who are not psychiatrists should be afforded the additional benefits of the psychotherapist-patient privilege. Lastly, advice is given concerning the physician''s conduct in relation to his duty to claim privilege under the new code.     

Spectres of Seppo: the afterlives of Finland's nuclear waste experts

This article examines how Finland's nuclear waste repository safety assessment experts summoned memories of Seppo: a deceased colleague whose ‘spectre’ was said to still ‘haunt’ their workplace. First, it tracks how Seppo appeared in predecessor parables: cautionary tales told about his death, which conveyed value judgements about how experts ought to act, engage, and aspire. Second, it explores how Seppo's long-time ‘right-hand man’ Gustav still felt haunted by his colleague's affective intensities, scientific vision, and sharp tongue. This led Gustav to prod his workmates to reconsider how they modelled Finland's ecosystems many millennia into the future. Studying this ethnographically revealed how traces of Seppo's past life infused living experts with emotions, opened them to alternative futures, and spurred them to rethink their professional values. This article concludes by introducing expert afterlives as a temporal, epistemic, and affective nexus that can shape how technocratic projects are organized and how expert knowledge is made.     

THE PSYCHODYNAMICS OF HYPERTENSION

Psychotherapeutic study of patients with essential hypertension shows evidence of massive repression of unacceptable feelings in many areas of the personality, predominantly feelings of rage and hostility. It appears that in the mentation of the hypertensive person, rage not only risks the loss of affection and approval by others, but is unconsciously equated by him with murderous loss of self-control. In addition, he characteristically has an inordinate fear of death.Intensive insight psychotherapy, when commenced early in a well-motivated patient, is very effective in the treatment of this disorder. As in any psychosomatic condition, the patient should be concomitantly treated by his general physician or by an internist.     

Communication in a chiropractic clinic: How A D.C. treats his patients

This study of a chiropractor and his patients represents the first interaction analysis of an alternative practitioner. Relationships between the types and quantities of communications in clinical exchanges and patient satisfaction with treatment are examined using both quantitative and qualitative analysis of verbal dialogue and clinical observations. Findings suggest that patient satisfaction is enhanced by a practitionerpatient relationship characterized by initial transmission of large amounts of comprehensible information successively supplanted by personal affective dialogue. New patients are usually unfamiliar with the chiropractic belief system and may have special communication needs due to the psychoemotional component to their, often chronic, problems. The chiropractor provides the patient with a structured, supportive environment and theoretical explanations designed to take the mystery out of process and problems. In essence, the chiropractor first manipulates a patient's belief structure before manipulating his or her physical structure, providing an analogous structural realignment in both the mind and body. Contrasts between biomedical and chiropractic clinical encounters are noted.     

Psychological Problems Of Dialogue In Light Of The Ideas Of M. M. Bakhtin And A. A. Ukhtomskii

Comparative examination of the scientific and philosophical ideas of Mikhail Mikhailovich Bakhtin and Aleksei Alekseevich Ukhtomskii is of interest from the standpoint of both the psychological theory of communication and the practice of psychological counseling, psychotherapy, and upbringing. Development of the applied areas of psychology poses the tasks of understanding the particular person and his individual problems and offering psychological assistance in the process of communication. To deal with these questions it is not sufficient to have scientific psychological training, i.e., knowledge of the general laws of personality development and communication; a capacity for personal communication as an aid to resolving human life problems is also necessary.     

NONVERBAL TREATMENT OF NEUROSIS—Techniques for General Practice

“Psychosomatic medicine” does not demand that the general practitioner function as a psychiatrist; rather, it is a psychiatric orientation that can increase the effectiveness of purely medical treatment for such conditions as neuroses. The general practitioner to whom the patient turns may achieve permanent results with nonverbal techniques where formal psychotherapy would be impracticable or unacceptable.The first aim is to relieve pressure so that the patient can regain his mental balance and thereby his self-confidence. Arts, hobbies, sports, and the like can be prescribed rather specifically according to the patient''s personality and needs. Nutrition can be improved simply at first by prescribing needed additions to diet rather than imposing restrictions. Vitamin deficiency may by itself be the cause of neurosis or more serious mental disease, whereas psychic stress by itself may create a need for additional vitamin intake. Hormone therapy may be extremely helpful but must be based on clear indication and limited to specific purposes.Since lack of sleep and rest quickly impairs mental function, it is important for neurotic persons to learn relaxation as a necessity for sleep. Sedatives may be used in a crisis but should be abandoned as soon as possible.With all drugs there are problems of excess and habituation. The least, the mildest, the shortest dosage is the ideal.The initial steps of psychotherapy are available to any physician: Establishing rapport, noting how complaints are stated, encouraging ventilation, winning confidence rather than immediate results.     

Interaction between Doxycycline and some Antiepileptic Drugs

The mean half life of doxycycline given to seven patients on long-term diphenylhydantoin treatment was 7·2 ± 0·4 hours. In five patients on long-term carbamazepine treatment the half life was 8·4 ± 1·4 hours. In four patients on combined diphenylhydantoin and carbamazepine treatment the half life was 7·4 ± 0·7 hours. All these were significantly shorter than a mean half life of 15·1 ± 1·0 hours when doxycycline was given to nine control patients. Therefore doxycycline in normal doses given to patients taking diphenylhydantoin or carbamazepine may fail to maintain the minimum inhibitory concentration necessary for proper bacteriostasis. When doxycycline is given in association with agents known to induce drug metabolism the serum concentration of the antibiotic should be watched to see that bacteriostatic levels are maintained.     

Knowing,Anticipating, Even Facilitating but Still not Intending: Another Challenge to Double Effect Reasoning

A recent administrative law decision in Victoria, Australia, applied double effect reasoning in a novel way. Double effect reasoning has hitherto been used to legitimate treatments which may shorten life but where the intent of treatment is pain relief. The situation reviewed by the Victorian tribunal went further, supporting actions where a doctor agrees to provide pentobarbitone (Nembutal) to a patient at some time in the future if the patient feels at that time that his pain is unbearable and he wants to end his life. The offer to provide the drug was described as a palliative treatment in that it gave reassurance and comfort to the patient. Double effect reasoning was extended in this instance to encompass potentially facilitating a patient’s death. This extension further muddies the murky double effect reasoning waters and creates another challenge to this concept.     

PSYCHIATRIC MANAGEMENT OF INTERSEXED PATIENTS

The psychiatric management of intersexed patients stems from an awareness that sexual identity is the result of a complex mixture of somatic and psychological components. Decisions in treatment are dependent on the appearance and correctability of the anatomic defects, the age of the patient, and the potential reversibility of the identifications contributing to the manifested sexual identity. In infants and small children, following proper diagnosis of somatic sex and an evaluation of degree of correctability of anatomical defects, decision can be made whether to bring up the child in his genetic sex or not. It is very difficult to change the sexual identity after two and a half years, except possibly in persons who already have considerable question as to their maleness or femaleness.In the psychiatric treatment of children with such disorders, the child and his family should be informed in understandable language what is being done, and the child and usually the parents should be involved in psychotherapy.With the adult, if treatment is necessary, supportive therapy, not psychoanalysis, should be used.     

Redesigning the bean seed germination experiment: an activity sheet suggestion

Abstract

Germinating a seed is presumably the first experiment made by a child in his life. So, it has an important place both in child’s scientific experience and understanding. Despite the significance of the experiment, the literature indicates that students possess various misconceptions related to the concepts of seed and seed germination. So, it is thought that this experiment should be focused on in more detail. The purpose of this paper is presenting a proper activity sheet for middle school students to perform this experiment effectively. Science teachers might follow it as an instructional tool in their courses. Thus it is expected to assist students explore the factors which are affective on bean seed germination.